Women's Health

Cholesterol Later in Life, Premature Deliveries Linked

Giving birth early seems to increase a woman's risk of having high cholesterol later, say researchers at a recent Society for Gynecologic Investigation meeting.

And that raises the chances of heart disease even further down the line for these women, the researchers add.

"Total cholesterol and LDL cholesterol were elevated in women who'd had a preterm birth, before 34 weeks," says study author Janet Catov, Ph.D., at the University of Pittsburgh School of Medicine.

Dr. Catov says it is hard to know yet whether there is something in the pregnancy or preterm delivery that triggers the high cholesterol, or if it is the high cholesterol that may have something to do with the preterm delivery.

She notes that "very early in pregnancy, women with preterm birth have elevated lipids, which may be exacerbated in pregnancy."

High or Low Cholesterol a Concern

Another recent study found that women with very low levels of cholesterol were also at risk of preterm birth, but Dr. Catov says this study showed that women on the very high end of cholesterol levels also went on to give birth prematurely.

"Perhaps there's a normal range, and if you're higher or lower, it could be a problem," she said.

In the current study, Dr. Catov and her colleagues compared 47 women who had had a preterm birth, defined as giving birth before 37 weeks of gestation, to 104 women who gave birth to full-term infants. Most of the women in the preterm group gave birth before 34 weeks of gestation.

Women who had other chronic medical conditions, such as preeclampsia or a baby with signs of growth restriction, were excluded from the study.

Blood samples were taken an average of 7.4 years after delivery.

Women who had given birth before 34 weeks of gestation had the highest levels of total cholesterol at 202.6 milligrams per deciliter (mg/dl). Women who gave birth between 34 and 37 weeks had levels of 190.1 mg/dl, and women who carried their babies to term had levels of 180.1 mg/dl.

After adjusting for race, smoking history, and body mass index, the researchers found that women who gave birth prematurely had a 2.3 times greater risk of developing cholesterol levels above 240 mg/dl, a level considered high risk by the American Heart Association.

Additionally, women who had had a preterm birth were 3.3 times more likely to have elevated LDL - the "bad" cholesterol - than women who gave birth to full-term babies.

Pregnancy and Health Later On Linked

Dr. Nieca Goldberg, at New York University, says, "What this study tells us is that a woman's previous medical history, particularly conditions that happen during pregnancy, may be a clue to her later heart disease risk.

"I would advise a woman who's had a preterm birth and who now has high cholesterol to have her cardiac risk factors evaluated at regular intervals, at least with a yearly physical," says Dr. Goldberg.

While Dr. Catov says these findings need to be duplicated in a larger study before any specific guidelines or recommendations can be made, she says it is a good idea to "keep your doctor apprised of your medical conditions and preterm births or other adverse pregnancy outcomes, and keep up to date with recommended screenings."

Always consult your physician for more information.

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What Is Cholesterol?

However, blood cholesterol is very specific to each individual and, for that reason, a full lipid profile is an important part of your medical history and important information for your physician to have. In general, healthy levels are LDL - less than 130 milligrams per deciliter (mg/dl) and HDL - greater than 40 milligrams per deciliter (mg/dl). A total cholesterol level below 200 mg/dL is considered desirable.

In some individuals who already have coronary artery disease (CAD) and/or who have an increased number of risk factors for coronary heart disease, a physician may determine that the LDL cholesterol level should be kept lower than 130.

Recent studies have shown that those who are at highest risk for a heart attack should lower their LDL cholesterol level to less than 100, and that an LDL cholesterol level of 70 or less may be optimal for those individuals at the very highest level of risk.

Medical treatment may include:

modification of risk factors - risk factors that can be changed include lack of exercise and poor dietary habits.

cholesterol lowering medications - medications used to lower lipids (fats) in the blood, particularly low density lipid (LDL) cholesterol. Statins are a group of antihyperlipidemic medications, and include simvastatin (Zocor®), atorvastatin (Lipitor®), and pravastatin (Pravachol®), among others.

Bile acid sequestrants - colesevelam, cholestyramine and colestipol - and nicotinic acid (niacin) are two other types of medications that may be used to reduce cholesterol levels.

Elevated cholesterol is a risk for many Americans.

About 105 million American adults have total blood cholesterol levels of 200mg/dL and higher, and of those about 36.6 million American adults have level of 240 or above.

Elevated cholesterol levels early in life may play a role in the development of adult atherosclerosis.

According to the American Heart Association, high blood cholesterol that runs in families will affect the future of an unknown (but probably large) number of children.